New Patient Forms


For patients coming in voluntarily or families recommending their loved ones to addiction or mental health recovery, please view and download the following forms as needed. You can either fill them out and fax them to us at 937-256-7801, or fill them out and bring them in with you to Access Hospital. 

Request for Voluntary Admission

Informed Consent for Administering Medication

Current Medications List

Visitor Confidentiality Statement

Access Ohio Hospital Handbook

Access Ohio AOD Handbook

Patient Belongings- Do's and Don'ts

Personal Belongings Log

  • Need help about your specific case, browse through our FAQs or write to us.

  • Learn more about what affects you or your family member. Stay informed.


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